Volunteer Application
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Authorization and Certification

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate discharge. I understand that Modus will conduct a background check (including a criminal background check and motor vehicle report) and drug screening as a condition of employment. I agree that, if I am employed, I will abide by all the rules and regulations of Modus. I further understand that nobody in Modus is authorized to enter into any written or verbal employment contracts with me for any definite period of time without express written consent. I also understand that my employment is “at-will” and may be terminated by me or by Modus at any time for any reason or for no reason at all, with or without prior notice.

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1519 S. Harvard Ave.

Tulsa, OK 74112

(918) 280-9563

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